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Direct evidence concerning the 'major role' of fluoride dentifrices in the caries decline. A 6-year analytical cohort study.

The role of fluoride (F) dentifrices in caries decline was investigated by assessing the effect of variation in their use on caries scores among teenagers. The material comprised 211 subjects aged about 11 years at base line and 18 years at the last examination. Pairs of posterior bitewing radiographs were assessed by one examiner. Information concerning dental health behavior was collected by questionnaire and about treatment received from dental records. A reversal of the traditional DFS gender difference occurred during teenage years. Multivariate regression analyses showed an inverse relationship between variation in F dentifrice use and current decay (D1S) at age 18 years (P < 0.04) and with caries incidence per year (D1FS) during the whole observation period (P < 0.02). Total explained variance in 6-year deltaD1FS scores was 29.8%, of which variation in toothbrushing behavior contributed 1.8 percentage points. While confirming the multifactorial nature of dental caries, these results also provided quantitative evidence for the role of variation in F dentifrice use in caries incidence and decline.

Adolescent↗

Soluble calcium/SMFP dentifrice: effect on enamel fluoride uptake and remineralization.

PURPOSE: To evaluate in situ the effect of soluble calcium on fluoride uptake and remineralization by human dental enamel from a sodium monofluorophosphate (SMFP) dentifrice. MATERIALS AND METHODS: Eight volunteers took part in this cross-over, double-blind design study performed in three phases of 45 days. During each phase of the experiment, the subjects wore an acrylic resin appliance containing four blocks of human dental enamel with artificial caries to evaluate fluoride uptake and remineralization by three dentifrices: SMFP containing CaCl2, SMFP, and placebo. After each phase, the enamel blocks were removed and the total fluoride uptake (ppm F) and microhardness (Knoop) were measured. Statistical analyses (ANOVA and Turkey's test) were done. RESULTS: There was no statistically significant difference between SMFP-CaCl2 and SMFP treatments regarding the amount of fluoride and microhardness data of treated enamel blocks as well as their areas under the curves, although both differed significantly (P < 0.05) when they were compared with placebo. However, the SMFP-CaCl2 treatment demonstrated the highest values on fluoride uptake and microhardness data. Furthermore, the microhardness data demonstrated 50% and 40% of remineralization for SMFP-CaCl2 and SMFP dentifrices, respectively.

Analysis of Variance↗

Efficacy of a triclosan/NaF dentifrice in the control of plaque and gingivitis and concurrent oral microflora monitoring.

PURPOSE: To compare the effect of a dentifrice containing 0.3% triclosan and 1100 ppm fluoride and a control dentifrice containing 1100 ppm fluoride on plaque, gingiva and the oral microflora in a long-term study simulating clinical usage. MATERIALS AND METHODS: 159 subjects entered the clinical study and 80 were randomly selected to participate in the microbiological evaluation. 71 subjects completed the detailed evaluation of the oral microflora after 6 months use. Plaque was collected at baseline, 3 months, and 6 months, and examined by darkfield microscopy, Gram stain, immunofluorescence, and selective and non-selective media. Changes in antimicrobial susceptibilities were determined for the first 6-month period and for 6 months post-therapy for 68 subjects who completed the entire study. Susceptibilities of whole plaque samples and MIC values for two pre-designated common plaque organisms, A. viscosus and V. parvula were performed. RESULTS: Multivariate ANOVA and non-parametric analyses revealed no statistical differences for any factor tested. No detrimental shifts were found in either; (1) the compositional make up of the normal flora, (2) the periodontopathic or cariogenic flora, or (3) the opportunistic flora in either group of dentifrice users. Both treatments resulted in decreases in Gram positive cocci over time. There was a reduction in spirochetes in the triclosan/fluoride group as compared to the control group. No overgrowth in opportunists, periodontal pathogens, or cariogenic flora was found in either group. No increase in the proportion of the whole plaque flora resistant to triclosan was found nor was an increase in the MIC values of either A. viscosus or V. parvula in either group. Overall, there appeared to be a general decrease in plaque bacteria in both groups over the course of the experiment.

Adolescent↗

A longitudinal comparison of tooth whitening resulting from dentifrice use.

The effect of twice-daily brushing with one of three different dentifrices (Arm & Hammer Dental Care, Arm & Hammer Dental Care Extra Whitening, Crest) on stain removal and tooth whitening was examined in 115 volunteers over a period of 12 weeks. The facial surfaces of 12 anterior teeth were assessed for stain using a published, modified version of a standard stain index. Whiteness was measured on teeth 8 and 9 using a single Vita Lumin-Vaccum Shade Guide for consistency. At baseline, the mean facial stain scores were significantly higher (p < 0.05-0.01) for both Arm & Hammer dentifrices than for Crest. In addition, the tooth shades, as indicated by the stain guide, specifically the b* values representing yellowness, were quantified using a Minolta spectrophotometer. Arm & Hammer Dental Care Extra Whitening formula was found to be significantly better than Crest at removing naturally occurring extrinsic stain. The difference between Arm & Hammer Dental Care Extra Whitening and Crest became significant (p < 0.01) after two weeks of use, and remained intact during the balance of the study, achieving p values of 0.0002 for at least one of the three assessed parameters (total stain, proximal, and facial) at weeks 4 and 12. The study also found that Arm & Hammer Dental Care produced a significant increase in tooth whiteness by week 12, whereas Crest showed no such increase at any time during the study. These results suggest that the two Arm & Hammer Baking Soda products are more effective in reducing stain and increasing whiteness than the standard silica-based dentifrice. Their effectiveness is not related to abrasivity since they are less abrasive to tooth enamel than the silica-based product tested.

Adolescent↗

Treatment of orthodontic white spot lesions with a remineralizing dentifrice applied by toothbrushing or mouth trays.

This pilot study investigated the effect of a remineralizing fluoride dentifrice (Enamelon) on newly formed incipient carious lesions using two methods of application. Teenage orthodontic patients with obvious white spot lesions on their teeth were selected to begin treatment within 30 days after debanding. At baseline, the surface enamel of the test teeth was cleaned by air etching with 50 microns alumina at 150 psi. Lesion size (mm2) was measured using a calibrated periodontal probe and surface appearance was quantified as shiny (0), dull (1), or chalky (2). Twice daily for 3 months, one group with a total of 27 lesions brushed with the remineralizing dentifrice, while a second group with 41 total lesions brushed and used a mouth tray to apply the paste directly to the lesions for 5 min. In order to promote treatment compliance, test group assignment was based on subject and parental preference. After 1, 2, and 3 months, lesion size was reduced by 5% (ns), 10% (p < 0.05) and 22% (p < 0.01), respectively, for the brushing group, and 16% (p < 0.05), 37% (p < 0.01) and 30% (p < 0.01) for the combined brushing and tray group, respectively. The dull appearance of the lesions treated by brushing improved slightly over 3 months. However, the lesions receiving combined brushing and tray applications became significantly (p < 0.01) less dull by 28%, 44% and 61% after 1, 2, and 3 months, respectively, indicating the formation of a shiny, intact surface layer. In conclusion, brushing with a remineralizing dentifrice significantly reduced the size of new orthodontic white spots within 2 months, while brushing combined with topical tray applications reduced lesion size within 1 month with concomitant formation of a shiny enamel surface layer. Thus, the combined brushing and mouth tray treatment significantly accelerated the remineralization process.

Adolescent↗

Effects of a high-bicarbonate dentifrice on intraoral demineralization.

Dentifrices available on the market today contain sodium bicarbonate in a wide range of concentrations. Anticaries efficacy has been demonstrated for these dentifrices in a variety of tests. New insights were gained in the present study in which the effect of a high-bicarbonate dentifrice on the sucrose-induced demineralization of tooth enamel in situ was examined. With the intraoral Delta Ip system it is possible to follow the minute changes in tooth enamel that essentially model the daily episodes of demineralization accompanying the ingestion of various foods. The results revealed a pronounced effect on the pH of the test plaque and a considerable reduction in mineral loss from the enamel. The effect persisted from more than 1 hour and, during that time, appeared to predominate over the effect of fluoride. These findings suggest that bicarbonate may provide additional protection against the loss of tooth enamel. Such effects may be significant for the design of new high-bicarbonate products.

Animals↗

Effects of a high-bicarbonate dentifrice on intraoral demineralization.

Dentifrices available on the market today contain sodium bicarbonate in a wide range of concentrations. Anticaries efficacy has been demonstrated for these dentifrices in a variety of tests. New insights were gained in the present study in which the effect of a high-bicarbonate dentifrice on the sucrose-induced demineralization of tooth enamel in situ was examined. With the intraoral Delta Ip system it is possible to follow the minute changes in tooth enamel that essentially model the daily episodes of demineralization accompanying the ingestion of various foods. The results revealed a pronounced effect on the pH of the test plaque and a considerable reduction in mineral loss from the enamel. The effect persisted for more than 1 hour and, during that time, appeared to predominate over the effect of fluoride. These findings suggest that bicarbonate may provide additional protection against the loss of tooth enamel. Such effects may be significant for the design of new high-bicarbonate products.

Animals↗

The scientific rationale and development of an optimized stannous fluoride dentifrice, Part 1.

Stannous fluoride has been recognized as an effective anticavity therapeutic agent since the early 1950s. There has recently been a resurgence in activity to discover ways to fully exploit its documented antimicrobial activity. Through the use of targeted in vitro methodology to predict in vivo efficacy, a highly optimized stannous fluoride dentifrice has been developed. Careful selection of stabilizing agents formulated into a unique system has resulted in a Colgate Optimized Stannous Fluoride (COSF) dentifrice that has been proven to simultaneously help control supragingival plaque, gingivitis, supragingival calculus, and caries. Furthermore, the COSF dentifrice has been clinically shown not to cause the traditional stannous fluoride staining of dentition.

Bacteria↗

The effect of zinc chloride dentifrices on plaque growth and oral zinc levels.

The antiplaque potential of zinc salts has been previously demonstrated. The purpose of the present investigation was to establish the effect of zinc chloride dentifrices on plaque growth and on the concentration of zinc in saliva and plaque. Zinc levels in saliva and plaque were measured by atomic absorption spectrophotometry. Elevated zinc levels were observed in saliva and in plaque for 1 hour after contact with a zinc chloride dentifrice. Increased concentrations of zinc were also observed in plaque residue. Further analysis of data showed that subjects with high rates of plaque growth benefited more from the zinc dentifrices than did those with low rates of plaque growth.

Adult↗

Triclosan/copolymer/NAF dentifrice prophylaxis, reduced etching time and shear bond strength of a resin composite to enamel.

This study evaluated the effect of a prophylaxis with a triclosan/copolymer/NaF dentifrice (Colgate Gum Protection Formula) and a reduced etching time with 37% phosphoric acid gel on the shear bond strength of a resin composite to enamel. 60 human extracted permanent molars were used. A flat enamel surface was obtained with 600 grit SiC paper and cleaned with a rubber cup and a water slurry of fine flour of pumice. The teeth were randomly distributed into 4 groups of 15 teeth each: Group 1: Pumice prophylaxis with a rubber cup, etched for 30 seconds; Group 2: Pumice prophylaxis, etched for 60 seconds; Group 3: Triclosan/copolymer/NaF dentifrice prophylaxis, etched for 30 seconds; Group 4: Triclosan/copolymer/NaF dentifrice prophylaxis, etched for 60 seconds. After etching, rinsing and drying, an unfilled resin (Coe Bond) was thinly applied with a brush and cured for 30 seconds. A nylon ring was placed over the area and filled with a light-cured resin composite (Occlusin). The teeth were thermocycled for 500 cycles and sheared with a knife-edged blade in an Instron running at a crosshead speed of 1 mm/min. The results in MPa were as follows: Group 1: 18.84 +/- 7.08; Group 2: 22.65 +/- 4.37; Group 3: 18.79 +/- 5.77; Group 4: 19.62 +/- 6.13. An ANOVA showed that there was no statistically significant difference among the groups. Enamel fracture occurred in 20% (3/15) in Group 1, 53% (8/15) in Group 2, 20% (3/15) in Group 3, and 47% (7/15) in Group 4.(ABSTRACT TRUNCATED AT 250 WORDS)

Acid Etching, Dental↗

Caries preventive effect of high fluoride and xylitol containing dentifrices.

Dental examinations were conducted in 1987 on 520 of the 753 children who fully participated in a three-year field-trial, 1983-1986, of the anticaries effect of dentifrices containing fluoride and xylitol. The prevalence of decayed (D), missing (M) and filled (F) permanent teeth differed significantly among the five treatment groups. Caries prevalence was inversely related to the level of fluoride, 1250, 2500 and 5000 ppm, in the dentifrice used, but was not associated with the presence or absence of 15 mg percent xylitol. The age, number of children, and number of erupted teeth were unequally dispersed among treatment groups. The DMF teeth scores showed non-normal distributions and nonhomogeneous variances. Following an exploratory scrutiny, the DMFT data were transformed to normal distributions for intra- and inter-treatment-group evaluation. All groups showed positive, significant regressions of DMF scores with the age of the children and an inverse significant regression with DMFT scores in relation to the fluoride content of the dentifrice under test.

Adolescent↗

Clinical effectiveness of a triclosan/copolymer/sodium-fluoride dentifrice in controlling oral malodor: a three-week clinical trial.

The purpose of this study was to compare the effectiveness of a commercially available, clinically proven, American Dental Association (ADA)-Accepted dentifrice containing 0.30% triclosan, 2% polyvinylmethylether/maleic acid (PVM/MA) copolymer, and 0.243% sodium fluoride in a 10% high-cleaning silica base (Colgate Total Advanced Fresh) to a commercially available, clinically proven, ADA-Accepted control dentifrice containing 0.243% sodium fluoride in a silica base (Colgate Cavity Protection Winterfresh Gel) for the management of oral malodor in a 3-week, randomized, double-blind longitudinal clinical trial. A panel of four expert judges used a nine-point hedonic scale to evaluate breath odor using a protocol designed in concordance with the ADA Draft Acceptance Program Guidelines for Products Used in the Management of Oral Malodor. After a baseline evaluation, prospective study subjects who scored above the threshold value for unpleasant breath odor were stratified by score and randomized into two treatment groups. Subjects were provided with a soft-bristled toothbrush and brushed their teeth thoroughly in their regular and customary manner for 1 minute with their assigned dentifrice, twice daily. Before oral-malodor evaluations, the subjects refrained from eating odorigenic foods and did not use dental hygiene procedures, breath mints, or mouth rinses. Eighty-one adult men and women from Chengdu, China, completed the study. Throughout the study, the mean breath-odor scores observed in the Colgate Total Advanced Fresh toothpaste group for both daytime and overnight were within the range of values associated with pleasant breath odor, were statistically significantly lower than the corresponding mean scores for the control group, and also represented statistically significant reductions from baseline. Relative to the baseline score, more than 80% of the subjects in the Colgate Total Advanced Fresh toothpaste group demonstrated a 3.2 or more unit reduction in organoleptic scores at every postbaseline breath-odor evaluation. Thus, the overall results of the double-blind clinical study support the conclusions that Colgate Total Advanced Fresh toothpaste is efficacious for the control of oral malodor for up to 12 hours in the daytime and up to 12 hours overnight.

Adolescent↗

Rationale for the daily use of a dentifrice containing triclosan in the maintenance of oral health.

This paper provides an overview and summary of the data that demonstrate the effectiveness of a dentifrice containing triclosan/copolymer/fluoride in significantly reducing plaque, calculus, gingivitis, and the onset and progression of periodontitis. The caries-preventive benefit of the triclosan/copolymer/fluoride dentifrice was at least as good as that of a fluoride dentifrice. No evidence of bacterial resistance or the development of pathogenic or opportunistic bacteria was observed.

Anti-Infective Agents, Local↗

The effect of a dentifrice in the prevention of recurrent aphthous stomatitis.

PURPOSE: A multicenter, double-blind, randomized, placebo-controlled clinical trial was conducted to determine the efficacy of an experimental dentifrice on the prevention of recurrent aphthous stomatitis (RAS). MATERIAL AND METHODS: A 3-month pretrial period was used to self-record data pertaining to the frequency, ulcer size, duration, and pain associated with ulcers. Thirty-six participants, who reported at least 3 RAS episodes or 30 days with RAS during the pretrial period, completed the study. Following a stratified randomization for age, sex and disease severity, the participants received the experimental dentifrice (T) or the placebo (C). The test period comprised 3 months of self-evaluation of number of ulcers, size and location. Pain related to RAS was estimated by the use of a Visual Analogue Scale (VAS). RESULTS: Symptoms were found to decrease in both groups when the pretrial and test periods were compared, although no statistical difference was reached in the C group. A statistically significant difference between the two time periods was obtained for the T group concerning the number of days with ulcers (p < 0.025) and VAS (p < 0.010). Of more clinical importance was the observation that 50% of the patients in the T group reported a more than 50% reduction in days with ulcers compared to 17% in the C group. CONCLUSIONS: The dentifrice may be used as a treatment strategy for a subgroup of patients with RAS in view of the low adverse effects and the benefit of using a treatment modality that is a part of daily routines.

Adolescent↗

A study of children's taste and visual preferences in dentifrices.

Variables and gimmicks can make choosing a dentifrice for a child complicated. Various flavors, colors, shapes, consistency, labelling, and type of dispensers provide a constellation of choices for the consumer. This study sought to determine whether children actually prefer the dentifrices designed for them. Visually the child-oriented products were preferred; modern containers were preferred over the traditional. In terms of taste, however, "child-flavored" dentifrices were not preferred over the regular flavor of the same brand, when one is tasted after the other.

Binomial Distribution↗

A study to compare the effects of two dentifrices on adult dental calculus formation.

In a three month double-blind clinical trial, a tartar control dentifrice formulation containing soluble pyrophosphates was compared to a placebo formula. Both formulations contained sodium fluoride. Subjects on the active dentifrice showed a 38% reduction in calculus severity and a 25% increase in calculus-free sites compared to the placebo group. Despite obvious differences in inactive excipients, these values are similar to reported results from other commercially available tartar control dentifrices. No untoward side effects occurred throughout the test period.

Adolescent↗

[Anticalculus dentifrices. A new era in preventive dentistry?].

Anticalculus toothpastes are available on the market. Toothpastes with Zinc compounds interfere mainly with the plaque formation. Dentifrices containing pyrophosphate give the highest reductions in calculus formation. The inclusion of pyrophosphate in a fluoride containing dentifrice did not interfere with the cariostatic action of fluoride on tooth enamel. The influence of anticalculus dentifrices on root caries and root hypersensitivity are, so far, not documented. Fundamentally, a lot of doubt still exists about the precise role of supragingival calculus formation in the onset of periodontal disease.

Dental Calculus↗

Abrasive properties of commonly used dentifrices.

This study was conducted to examine the effect of various dentifrices on the abrasion of acrylic resin and extracted human tooth. The influence of the difference in the hardness of the filament of the toothbrush on the abrasion was also studied, using three kinds of toothbrushes. The specimens (acrylic resin and extracted human tooth) were brushed 3,000 times by the back- and -forth stroke movement using a toothbrushing machine for two hours. The surface irregularities of the specimen were analyzed by the surface analyzer and observed by the scanning electron microscopy before and after the brushing procedure. Moreover, the weight loss of the test specimens of the acrylic resin materials was determined, weighing them by a microbalance before and after brushing. The abrasiveness of the dentifrices showed a wide range, but the abrasiveness of the toothbrush itself was not observed. All dentifrices except one which did not contain the abrasive materials had abrasive effects on both the acrylic resin and human tooth. There was a high correlation (r = 0.96) between the weight loss and the surface irregularities in the case of acrylic resin.

Acrylic Resins↗